Active NPI
George M. Duncan, DDS
- Dentist
- Dunlap, IL
National Provider Identifier
1255512273
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019025983
- Practice address
- 11825 State Route 40
Suite 100
Dunlap, IL 61525-8842 - Phone
- (309) 243-8980
- Fax
- (309) 243-8983
- NPI assigned
- Nov 19, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019025983 | IL | Primary |
Addresses
Primary practice location
11825 State Route 40
Suite 100
Dunlap, IL 61525-8842
Mailing address
11825 State Route 40
Suite 100
Dunlap, IL 61525-8842
Phone (309) 243-8980
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019025983 | IL | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1195430400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348704000000",
"number": "1255512273",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11825 STATE ROUTE 40",
"address_2": "SUITE 100",
"city": "DUNLAP",
"state": "IL",
"postal_code": "615258842",
"telephone_number": "309-243-8980",
"fax_number": "309-243-8983"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11825 STATE ROUTE 40",
"address_2": "SUITE 100",
"city": "DUNLAP",
"state": "IL",
"postal_code": "615258842",
"telephone_number": "309-243-8980",
"fax_number": "309-243-8983"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUNCAN",
"first_name": "GEORGE",
"middle_name": "M.",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-11-19",
"last_updated": "2012-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019025983",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dunlap, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.